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Esansiyel Hipertansiyon Hastalarında Sosyo-ekonomik Düzey Farklılığı ve İlaç Uyuncu

DRUG COMPLIANCE AND THE SOCIO-ECONOMIC LEVEL DIFFERENCE IN THE ESSENTIALLY HYPERTENSIVE PATIENTS

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Abstract (2. Language): 
Objective: To investigate the factors influencing drug compli¬ance in essentially hypertensive patients. Material and Method: The age, social security, monthly inco¬me, occupation, education level, duration of hypertension of 95 patients (74 women and 21 men) were evaluated in an outpatient hypertension clinic. For evaluating the drug comp¬liance, the difficulties they faced, the reasons of stopping the therapy and the non-pharmacologic methods they have been using for regulation of hypertension were asked. The difficul¬ties; D1: purchasing problem due to the high price, D2: forgetting the medication, D3: being not aware of the obligation of medical treatment, D4: stopping the treatment conceiving that it is harmful, D5: the lack of patient information, D5: ces¬sation of medication for feeling (him) herself healthy. Regula¬tion methods; R1: nonsalty diet, R2: weight reduction, R3: exercise, R4: using herbal products. Results: Compared to the middle and middle-high income grup, the low income grup has a longer duration of hyperten¬sion and drug administration, as (x=5.36, p<0.05), (t—2.81, p<0.01). Patients who have faced the difficulties D3, D5, D6 have had a longer duration of stopping the treatment, as (t=-4.30, p<0.001), (t=-2.81, p<0.01), (t=-2.81, p<0.01). There wasn't any difference between the group using non-pharma-cologic methods. Conclusion: We have found a negative correlation between drug compliance and the education and socio-economic levels in the essentially hypertensive patients. We consider that, in¬forming patients about their diseases and medication would improve the drug compliance for chronically ill patients.
Abstract (Original Language): 
Amaç: Çalışmamız, esansiyel hipertansiyon hastalarında ilaç uyuncunu etkileyen sosyo-ekonomik faktörleri araştırmak amacıyla planlandı. Yöntem: Hipertansiyon polikliniğinde takip edilen esansiyel hi-pertansiyonlu 74 kadın, 21 erkek, toplam 95 hastada hipertansiyonun süresi, meslek ve eğitim durumu, aylık gelir düzeyi ve sosyal güvence belirlendi. ilaç uyuncunu saptamak amacıyla, karşılaştıkları güçlükler, ilaca ara verme nedenleri ve hipertansiyon regülasyonunda kullandıkları non-farmakolojik yöntemler soruldu. Güçlükler; G1: fiyatının yüksek oluşu nedeniyle alamama, G2: unutkanlık nedeni ile kullanamama, G3: ilaç kullanma zorunluluğunun bilincinde olmama, G4: zararlı olduğunu düşünerek ilacı bırakma, G5: hekimin yeterli bilgi vermemesi, G6: hastanın kendisini iyi hissederek ilacı kesmesi. Regülas-yon yöntemleri; R1: tuzsuz diyet, R2: kilo verme, R3: uygun egzersiz, R4: bitkisel ürün kullanımı olarak belirlendi. Bulgular: Hipertansiyon ve ilaç kullanım süreleri, düşük gelire sahip ve sosyal güvencesi olmayan grupta, orta ve orta-üstü gelir düzeyinde olan gruba kıyasla sırasıyla (x=5.36, p< 0.05), (t=-2.69, p<0.01) daha uzundu. G3, G5 ve G6 ile karşılaşan hastalarda ilaca ara verme süresi sırasıyla (t=-4.30, p<0.001), (t=-2.43, p<0.05), (t=-2.81, p<0.01) daha yüksekti. Non-farma-kolojik yöntemler kullananlar ve kullanmayanlar arasında bir fark gözlenmedi. Sonuç: Çalışmamızda eğitim ve sosyo-ekonomik düzey düşüklüğünün, esansiyel hipertansiyon hastalarında ilaç uyun-cunu olumsuz yönde etkilediği saptandı. Hastaların hastalıkla¬rı ve ilaçları hakkında daha fazla bilgi sahibi olmaları ile kronik hastalıklarda tedaviye uyuncun artabileceğini düşünmekteyiz.

REFERENCES

References: 

1. Kaplan NM. Clinical Hypertension. 6. baskı. Baltimore, Williams and Wilkins 1994; 1.
2. Stampler J. Blood pressure and high blood pressure. Aspect of risk. Hypertension 1991; 1(18): 95.
3. Braunwald E, Kurt JI, Petersdorf RG, Wilson JD, Martin JB, Fauci
AC. Harrison's Principles of Internal Medicine, 12. baskı. International Edition Mc Graww, Hill Inc 1991; 1: 1001-5.
4.
Ero
l Ç. Hipertansiyon ve tedavisi. Med Network Kardioloji Dern. Hipertansiyon ve Koroner Risk Faktörleri Eki 1995; 1: 3-10.
5. Kaplan NM. Guidelines for the treatment of hypertension; An American view. J Hypertension 1995; 113-7.
6. The Sixth Report of The Joint National Committee on Prevention, Detection, Evolution and Treatment of High Blood Pressure ( JNC VI) 1997; 5.
7. Delporte JP, Rarive G. Pharmaco-economic aspects of the treatment of hypertension. Rev Med Liege 1998; 259-64.
8. Van der Meer JB, Mackenbach JP. Course of health status among chronically ill persons: Differentials according to level of education. J Clin Epidemiol 1998; 1(3): 171-9.
9. Colhoun HM, Hemingway H, Poulter NR. Socioeconomic status and blood pressure: an overview analysis. J Hum Hypertens 1998; 12(2): 91¬110.
10. Holme I, Helgeland A, Hjermann I, Leren P. Socio-economic status as a coronary risk factor: the Oslo Study. J Epidemiol Community Health
1994; 48(4): 4348-54.
11. Mackenbach JP. Socioeconomic health differences in The Netherlands: a review of recent empirical findings. JAMA 1998; 280(4): 356-62.
12. Luoto R, Pekkanen J, Uetela A, Tuomilehto J. Cardiovascular risks and socioeconomic status: differences between men and women in Fin¬land. J Epidemiol Community Health 2000; 54(2): 108-13.
13. Osler M, Gerdes LU, Davidsen M, Bronnum-Hansen H, Madsen M, Jorgensen T. Socioeconomic status and trends in risk factors for cardi¬ovascular diseases in the Danish MONICA population, 1982-1992. Soc Sci Med 1992; 34(3): 213-26.
14. Yu Z, Nissisen A, Vartiainen E, Song G, Guo Z, Zheng G. Associati¬on between socioeconomic status and cardiovascular risk factors in an ur¬ban population in China. J Clin Epidemiol 1994; 47(12): 1401-9.
15. Yu Z, Nissisen A, Vartiainen E, Song G, Guo Z, Tian H. Changes in cardiovascular risk factors in different socioeconomic groups: seven year trends in a Chinese urban population. J Epidemiol Community Health
1999; 53(12): 757-64.
16. Bobak M, Herztman C, Skodova Z, Marmot M. Socioeconomic stas-tus and cardiovaskular risk factors in the Czech Republic. Ann N Y Acad
Sci 1999; 896: 262-77.
17. Robert SA. Community-level socioeconomic status effects on adult he¬alth. J Health Soc Behav 1998; 39(1): 18-37
18. Antonovksy A. Social Class, life expectancy and overall mortality. Mill-bank Mem Fund Q 1967; 45: 31-73.
19. Fein O. The influence of social class on health status. American and Bri¬tish research on health inequalities. J Gen Int Med 1995;10(10): 577-86.
20. Fox AJ, Goldblatt P. Socioeconomic differentials in mortality 1971-1975.(Office of Population Censuses and Surveys Series LSI) London:
HMSO, 1989.
21. Rose G, Marmot MG. Social class and coronary heart disease. Br Heart J 1981; 45: 13-9.
22. Smith GD, Shipley MJ, Rose G. Magnitude and causes of socioecono¬mic differentials in mortality: further evidence from the Whitehall Study. J Epi & Com Health 1990; 44: 265-70.
23. Smith GD, Neaton JD, Wenthworth D. Socioeconomic differentials in mortality risk among men screened for the multiple risk factor interventi¬on trial: in white men. Am J Public Health 1996; 86: 489-96.
24. INCLEN Multicentre Collaborative Group. Socioeconomic status and risk factors for cardiovascular disease: a multicentre colloborative study in International Clinical Epidemiology Network (INCLEN). Arch Intern
Med1997; 157(8): 873-81.
25. Pickering T. Cardiovascular pathways: socioeconomic status and stress effects on hypertension and cardiovascular function. J Womens Health
Gend Based Med 2000; 9(8): 905-15.
170 |
Ergün UGÖ, Yıldırım MY, Alparslan N | Esansiyel Hipertansiyon Hastalarında Sosyo-ekonomik Düzey Farklılığı ve ilaç Uyuncu
26. Choiniere R, Lanfontaine P, Edwards AC. Distribution of cardiovascu¬lar disease risk factors by socioeconomic status among Canadian adults.
J Epidemiol Community Health 2000; 54(9): 692-6
27. Iribarren C, Luepker RV, McGovern PG ve ark. Twelve-year trends in cardiovascular disease risk factors in the Minnesota Heart Survey. Are socioeconomic differences widening? Acta Med Scand Suppl 1982; 660:
147-51.
28. Neaton JD, Kuller LH, Borhani NO. Total and cardiovascular mortality in relation to cigarette smoking, serum cholesterol concentration, and di-astolic blood pressure among black and white males followed for up to fi¬ve years. Am Heart J1984; 108: 759-69.
29. Lowal SO, Olubodun JO. Alcohol consumption and heart failure in
hypertensives. Int J Cardiol 1996; 53(1): 81-5.
30. Bailey BJ, Carney SL. Hypertension treatment compliance; what do pa¬tients want to know about their medication? Prg-Cardiovasc-Nurs 1997;
23-8.
31. Olubodun JO. Inadequate blood pressure control in African hypertensi¬ves. Who is responsible. Patient. physician or government? Ethn Dis
1998; 8(2): 240-8.
32. Pineiro F, Gil V, Donis M. Factors involved in noncompliance with pharmacological treatment in arterial hypertension. Aten-Primario 1997;
20(4): 180-4.
33. Brown CM, Segal R. The effects of health and treatment perceptions on the use of prescribed medication and home made remedies among Afri¬can American and white American hypertensives. Soc Sci Med 1996;
43(6): 903-17.
34. Pavlik VN, Hyman DJ. Hypertensive awareness and control in an inner city African-American sample. J Hypertens 1997; 277-83.
35. Lotur-Perez J, Gutierrez-Vic'en T. Differences in therapeutic effort be¬cause of the socioeconomic level of patients with AMI. Soc Sant 1995;
9(46): 5-10.

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